AG OKs petitions by state nurses association

Signatures still needed to get state ballot slots

Voters may get to act on referendums that relate to hospital finances and nurse-patient ratios.

The state nurses association — which represents Baystate Franklin Medical Center nurses — said the initiatives, deemed constitutional by the attorney general this week, are necessary to create a clear picture of a hospital’s financial health and to ensure patient safety.

A Baystate Health official challenged the union’s motivation, arguing that if government officials or legislators thought these steps were necessary, they already would have enacted them during recent health-care reform programs.

One initiative would require hospitals and health care facilities, with the exception of rehabilitation or long-term care organizations, to publicly disclose all of their financial assets. Hospitals that exceed a certain relative level of income each year would need to put money into a state fund used to improve hospital’s federal Medicaid reimbursements.

It included a similar provision related to the salary of the hospital’s chief officer. If that individual’s salary is more than 100 times the compensation of a lowest-paid employee, the hospital would need to put more money into that state fund.

Steven Bradley, vice president of government and community relations and public affairs at Baystate Health, didn’t have a problem with the financial disclosure, arguing that his health system already provides most of its financial information to the state or federal government.

However, penalizing hospitals that earn more extra revenue is not a good idea, he said, because not-for-profit hospitals retain that money in a fund for capital projects. Putting restrictions on chief officer salaries could hurt Massachusetts hospitals in competition against other states, he said.

The other initiative approved by the attorney general this week would set limits on the number of patients a nurse could serve at once, an attempt by the state nurses to establish “safer staffing levels.” The ratios would vary slightly depending on the type of nurse. Medical-surgical nurses would serve no more than four patients at one time.

Hospitals would be fined $25,000 for each day they fail to follow the nurse-to-patient limits.

Bradley said that if there were unsafe staffing levels at hospitals, then the state’s department of public health would have already shut those units down.

The initiatives, which wouldn’t see legislative action or a spot on the ballot until sometime next year, require organizers to get nearly 69,000 signatures this fall.

Early next year, the state Legislature will have four months to act on any petitions that have enough signatures. If no action is taken by May 1, then an additional 11,500 signatures are needed for the petition to be included on the November 2014 state ballot.

Then, if residents vote in favor of the initiative, it will become law.